How does vasectomy work? A simple explanation

Vasectomy is a simple surgical procedure and can be easily performed in a doctor’s office under local anesthesia.

The vasectomy procedure can be performed in less than 15 minutes by a skilled provider and men can be back to work and sexual activity in two (2) days.

Vasectomy works by causing permanent blockage of the tubes
(vas deferens) that transport sperm to their storage areas inside the body.

If you have a basic understanding of male reproductive anatomy you can easily understand how vasectomy works to permanently prevent pregnancy.

By understanding reproductive anatomy not only will you have a better understanding of how vasectomy works but you will also have a better understanding of why many of the common myths about vasectomy are incorrect.

Each section below expands to explain key areas of the male reproductive system.

Male Reproductive Anatomy: Vasectomy Explained

Scrotum: Protecting the family jewels

The scrotum is composed of skin, very thin layers of muscular tissue, and a very tough layer of connective tissue called fascia. Each testicle is supported by it’s own connective tissue sac and this connective tissue is called fascia.

The scrotum is actually two smaller internal sacswithin a single external sacof skin. The smaller internal fascial sacs each contain, support, and protect a testicle. The thin muscular layer surrounds the fascial sacs and testicles and the muscular layer contracts or relaxes to raise or lower the scrotum to help regulate the internal temperature. The scrotum holds the testicles outside the body because human sperm require a temperature lower than body temperature for proper sperm production and development.

Testicular support is exclusively providedby the fascial sacs that surround each testicle and, to a lesser extent, the skin and muscle of the scrotum. The vas deferens (the tubes divided during a vasectomy) do not provide testicular support. When you have a vasectomy you will not experience a drop in the testicles or an elongation of the scrotum because the main support structures of the testicles are not involved in a vasectomy procedure.

Myth: After vasectomy your testicles will drop.Reality: Vasectomy will not cause your testicles to drop because the vas deferentia are not the main support for the testicles.

Blood vessels and nerves: Sustaining sperm and hormone production

The blood vessels provide blood supply to the scrotal structures and provide nourishment to the sperm and hormone making cells in the epididymis and testicles. The blood vessels also absorb hormones produced by the testicles and transport these hormones to the rest of the body. The nerves are adjacent to the blood vessels and we can simply say the nerves provide the necessary feedback to let you know when your jewels are in harms way.

A vasectomy has minimal impact upon the blood vessels and the nerves of the scrotum. The scrotal nerves are mostly part of the visceral nervous system. The visceral nervous system is thought of as a primitive network of nerves that work very well to transmit sensation but are not smart enough to always help the brain localize where pain is coming from.

Although most of us know scrotal nerves transmit pain extremely well, these nerves are much easier to anesthetize with local anesthetic when compared to other types of nerves and this is why vasectomy can easily be performed under local anesthesia.

Myth: After vasectomy sex will be less pleasurable.

Reality: Vasectomy does not involve the nerves and does not change the blood supply to the testicles. Many studies suggest improvement in sexual satisfaction after vasectomy for both men and women due to the removal of the fear of pregnancy.

Testicles: Making the hormone that makes you a man

The testicles are responsible for producing testosterone. Testosterone is absorbed by the blood vessels and transported throughout the body by the circulatory system. The hormones produced by the testicles also help sperm development in the epididymis. Vasectomy does not change the production of hormones.

Myth: After vasectomy your hormones will change and you will be less of a man.

Reality: Vasectomy does not decrease or change testosterone production. You will still be a man and your voice will be unchanged!

Epididymis: Sperm factory in constant production

The epididymis is the collection of small tubes on the outside of the testicles. The epididymis is where sperm are created. As sperm are made in the epididymis they move into the vas deferentia and up into the body. Hormones produced in the nearby testicles assist with sperm creation and maturation.

Myth: Vasectomy makes you stop making sperm.

Reality: Vasectomy does not stop sperm production in the epididymis; however, as the length of time increases after vasectomy the epididymis may begin to produce less sperm as a direct result of a vasectomy procedure. This is often unnoticeable and is only a problem if you are seeking a vasectomy reversal to restore fertility.

Vas deferens: Sperm highway

The vas deferens is the tube which connects the epididymis to the seminal vesicles inside of the body. There is usually one vas deferens tube that connects to each epididymis. Most men have two vas deferentia but some men can be born without a vas deferens on one or both sides.

As sperm are gradually produced they slowly travel up the vas deferentia and are stored inside the body in the seminal vesicles.

Vasectomy interrupts the transport of sperm. The vas deferens can best be thought of as the ‘transport highway for sperm’. Interruption of the vas deferens stops the transportation of sperm but does not alter or otherwise change the testicles’ production of hormones or the continued creation of sperm.

Myth: After vasectomy everything changes.Reality: Toasters were designed to make toast and lawn mowers designed to cut grass.Vasectomy is a procedure which only blocks transport of sperm up the vas deferens. If you were to have a rare vasectomy complication you could experience change but most men will not experience any noticeable change after vasectomy.

Seminal vesicles: Sperm storage area

Two seminal vesicles store sperm

Each vas deferens joins upstream with a seminal vesicle. The seminal vesicles are important because they store sperm and produce fluid that nourishes sperm and helps sperm transport during ejaculation.

A vasectomy interrupts the transport of sperm to the seminal vesicle storage area. Even with a successful vasectomy live sperm will remain in the seminal vesicles until they are emptied.

Failure to use a back up method during the first three months after vasectomy is the most common reason for pregnancy.

Myth: Vasectomy is instantly effective.

Reality: Vasectomy instantly causes interruption of sperm transport but after vasectomy you have live sperm stored in the seminal vesicles. Pregnancy is possible until these sperm are cleared.

Prostate: Providing the fluid for sperm transport

Prostate provides fluid for sperm transport

The seminal vesicles and the prostate secret over 98% of the fluid released during ejaculation. The actual volume of sperm in the ejaculate is very small.

Describing a large cup of coffee provides a great analogy for how much fluid the prostate and seminal vesicles provide to the ejaculate. The coffee in the cup is comparable to the fluid released during ejaculate. The sperm in the ejaculate add as much volume as would several packets of sugar when added to a large cup of coffee, which is essentially an unnoticeable amount of volume.

After vasectomy some men may notice a slight change in the color of their ejaculate because of the absence of sperm but the volume of fluid is only minimally decreased and often not noticeable.

Myth: After vasectomy the amount of fluid you ejaculate during intercourse decreases. Vasectomy causes prostate problems.

Reality: Vasectomy does not decrease the amount of fluid during ejaculation. Vasectomy has no involvement with the prostate.

Image compliments of Advanced Meditech

During a vasectomy procedure an opening is simultaneously made in the skin, thin muscle layer, and fascial layer of the scrotum and each vas deferens is exposed, divided, and permanently closed.

Vasectomy is intended to achieve one result: permanent birth control.

After the vasectomy the seminal vesicles must be emptied of remaining sperm and only then vasectomy can be reliably counted on for permanent and highly effective birth control.

Not All Vasectomies Are Alike

There are three major types of vasectomy: Conventional vasectomy, no-scalpel vasectomy, and minimally invasive vasectomy. For more information on different vasectomy types…

What Our Patients Are Saying

"Dr. Monteith prepared me mentally for the pre, during and post procedure journey. He also provided me with all the tools necessary for a comfortable recovery. I'm definitely confident in this Dr's work, and especially glad at how little pain I experienced throughout the process. It would be worth it to visit Dr. Monteith no matter what state you have to travel from, I drove from Virginia."

- J.R.

"Very comforting and knowledgeable experience not only was the staff pleasant so was the atmosphere! I drove 3 hours so i did my research. I was impressed with the information, visuals, and on hand knowledge about what the procedure was all about. I felt like an expert after i left! Not to mention the 45 min in and out time. I will be recommending this to all my colleagues thank you!"

- J.W.

"Dr Monteith, and his staff, were all very professional about my decision to have a vastectomy. They informed me of the risks, the surgery procedure, and the post-surgery care. The procedure itself was relatively painless. I would rate this as a 2/10. I highly recommend Dr Monteith; he even sent me a text message after the surgery to give me a personal update on my procedure. The procedure was quick."

- S.E.

"If you're in the market for a Vasectomy you need to give Dr. Monteith a serious look. Just compare the information on his website to the information you'll get from other options around the triangle. It's hard to get solid answers on cost, procedure and expectations up front from other offices but A Personal Choice plays no games and has great informative well designed website. Dr. Monteith makes it easy!"

- J.P.

"Excellent care. I visited Dr. Monteith for a single visit appointment on a Friday. Very clean, comfortable office. Pleasant staff. The procedure was quick and I went back to work for a little while. The only pain I experienced was soreness beginning about 4 hours post procedure, lasting for 24 hours, then subsiding rapidly. I was fine by Monday. The office checked on me twice, no problems. I would recommend Dr. Monteith to anyone.

- M.D.

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